Kociecka W, Majchrowicz H, Szulc M
Klinika Chorób Pasozytniczych i Tropikalnych IMiChZ AM, Poznaniu.
Przegl Epidemiol. 1992;46(3):195-205.
The focus of trichinellosis was presented comprising 28 patients and resulting from consumption of the wild boar meat. Early confirmation of trichinellosis diagnosis in the first case (index case) and an accurate epidemiological analysis established that the patients became infected with Trichinella spiralis strain originating from natural environment. A severe clinical course was disclosed in the index case, moderate course of trichinellosis in 11 patients, a mild course in 15 cases and an abortive course in one patient. The most frequent trichinellosis symptoms included muscular pain (92.3% cases), fever above 38 degrees C (62.2% cases), conjunctivitis (53.3%), periorbital and facial oedema (42.9% cases); headaches and excessive sweating were less frequent (35.8%), while diarrhoea, hemorrhages to the fingernail beds and skin rush were noted in single cases only. No leukocytosis was detected in 15 patients (53.5%) and number of acidophilic granulocytes was normal in 8 patients (28.5%) including 5 patients with moderate course of the disease. Also, no full correlation was detected between severity of the clinical course and anti-Trichinella antibody titres. Increased activity of a muscular enzymes creatine kinase (CPK) could be detected in 27 patients and increased activity of lactic acid dehydrogenase (LDH) in 9 patients. The increase in muscle enzyme activity (CPK in particular) in some patients failed to correlate with the severity of the clinical course. In 10 patients parasitological and histological study of muscle tissue biopsies was performed to determine intensity of the invasion and the character of pathomorphological lesions.
旋毛虫病疫情报告包含28例患者,病因是食用了野猪肉。首例患者(索引病例)的旋毛虫病诊断得以早期确认,准确的流行病学分析表明,这些患者感染了源自自然环境的旋毛虫菌株。索引病例呈现出严重的临床病程,11例患者为中度病程,15例为轻度病程,1例为顿挫型病程。旋毛虫病最常见的症状包括肌肉疼痛(92.3%的病例)、体温超过38摄氏度(62.2%的病例)、结膜炎(53.3%)、眶周和面部水肿(42.9%的病例);头痛和多汗症状较少见(35.8%),而腹泻、指甲床出血和皮疹仅在个别病例中出现。15例患者(53.5%)未检测到白细胞增多,8例患者(28.5%)嗜酸性粒细胞数量正常,其中包括5例病程为中度的患者。此外,临床病程严重程度与抗旋毛虫抗体滴度之间未发现完全相关性。27例患者可检测到肌肉酶肌酸激酶(CPK)活性增加,9例患者乳酸脱氢酶(LDH)活性增加。部分患者肌肉酶活性增加(尤其是CPK)与临床病程严重程度无关。对10例患者进行了肌肉组织活检的寄生虫学和组织学研究,以确定感染强度和病理形态学病变特征。